Oral Presentation ESA-SRB-AOTA 2019

The impact of surgical menopause on body Composition, bone and metabolic parameters: a cross sectional analysis (#253)

Kathy Fu 1 2 , Christopher White 3 , Leon Botes 4 , Lesley Andrews 4 , Angela Sheu 2 5 6
  1. Prince of Wales Hospital, Randwick, New South Wales, Australia
  2. St Vincent's Hospital, Darlinghurst, NSW, Australia
  3. Department of Endocrinology, Prince of Wales Hospital, Randwick, NSW, Australia
  4. Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, NSW, Australia
  5. Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
  6. St Vincent's Clinical School , UNSW Medicine , Randwick, NSW, Australia

BACKGROUND: Natural menopause induces adverse body composition1, bone and metabolic changes. We aimed to examine whether similar changes occur after surgical menopause (SM), which differs by earlier age and the lack of peri-menopausal transition. SM women have increased risk of bone loss2; higher rates of cardiovascular disease are also observed3 with conflicting data about underlying mechanisms4,5.

METHODS: 85 women with previous risk-reducing salpingo-oophorectomy (RRSO) for high oncology risk were compared with 30 age-matched friends. Dual Energy Xray Absorptiometry (DXA) was performed measuring bone density and body composition. Fasting blood samples for bone turnover, biochemical menopausal status, and glucose homeostasis were measured. RRSO women on HRT were excluded. Statistical analysis was conducted with Anova, Spearman’s correlations and backwards linear regression.

RESULTS: As a cohort, RRSO women had higher total fat mass (p=0.047) and fasting insulin levels (p=0.014) and trended towards higher BMI (p=0.064) and truncal fat mass (p=0.079) than age matched controls.

On subgroup analysis, RRSO women <2.5 years post-operatively had higher weight (p=0.040) and lean mass (p=0.042) than controls and trended towards higher total fat mass (p=0.077), truncal fat (p=0.099) and BMI (p=0.081). No differences with increasing duration since RRSO were seen (Fig 1).

Women undergoing RRSO within 2.5 years also exhibited higher P1NP levels (p=0.003) and trend towards higher alkaline phosphatase (p=0.058) (Table 1). This was associated with lower PTH (p=0.02) despite similar calcium, phosphate and vitamin D levels. These parameters returned to baseline >2.5 years post-RRSO.

There was significant correlation between total and trunk fat mass and bone markers (Vitamin D, P1NP and ALP) after controlling for age in both groups.

CONCLUSION: Fat mass, weight and bone turnover changes are correlated in women undergoing SM compared to controls, and all increase detrimentally within 2.5 years after RRSO. These changes appear to attenuate with increasing duration since RRSO.

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